A BASSC POLICY MONOGRAPH EMANCIPATING FROM FOSTER CARE IN THE BAY AREA:

Transcription

1 A BASSC POLICY MONOGRAPH EMANCIPATING FROM FOSTER CARE IN THE BAY AREA: What Types of Programs and Services are Available for Youth Aging Out of the Foster Care System? Sonja Lenz-Rashid, PhD, LCSW Assistant Professor San Francisco State University School of Social Work Funded by the Zellerbach Family Foundation San Francisco, CA January 2006

2 CENTER FOR SOCIAL SERVICES RESEARCH The Center for Social Services Research (CSSR) conducts research, policy analysis, program planning, and evaluation toward the improvement of the publicly supported social services. Housed in the School of Social Welfare at the University of California at Berkeley, the Center responds to the concerns of community professionals and consumers of services to develop research activities that are practice and policy relevant. The focus of our work is on populations who are considered needy or disadvantaged, including victims of child abuse and neglect, the chronically mentally ill, the aged, the medically indigent, and the poor. Human services agencies that provide assistance to these populations also are studied at the Center through our analyses of agency management, finance, professional development, and service systems. BAY AREA SOCIAL SERVICES CONSORTIUM RESEARCH RESPONSE TEAM The Bay Area Social Services Consortium (BASSC) was founded in 1987 and is composed of the Directors of Bay Area county social service and human service agencies, deans of the Bay Area graduate social work departments, and foundation representatives. The mission of BASSC includes professional development and education programs, applied research to support evidence-based practice, and periodic reports on policy implementation issues. Housed at CSSR, the BASSC Research Response Team was organized in 1995 to respond rapidly to the emerging needs of county social service agencies for information about their changing environments. Small-scale research projects are undertaken in close collaboration with agency administrators and program staff. For additional copies of this report go to the BASSC website at < or, for other CSSR reports, go to the CSSR website < 2

3 TABLE OF CONTENTS Executive Summary I. Introduction Youth Aging Out of Care 10 California Outcomes II. General Outcomes for Adolescents in Placement.. 11 Youth Aging Out of Foster Care Housing and Homelessness Housing Services Outcomes Employment and Financial Self-Sufficiency Employment Training Outcomes Education Mental Health Needs Social Support Lesbian, Gay, Bisexual, Transgendered, Queer Youth Substance Use Incarceration III. Description of Bay Area Interventions 23 Independent Living Skills Programs Housing Transitional Housing Placement Program (THPP) Transitional Housing Program-Plus (THP-Plus) Federal HOME Funds Housing Authority Funding Transitional Living Programs Permanent Housing Education Chafee Grant for Higher Education Guardian Scholars Programs School District Foster Youth Program Employment Mental Health EPSDT Other Mental Health Services Other Major Bay Area Initiatives Family to Family California Connected by 25 3

4 California Permanency for Youth Project Family Finding Gateway for Disadvantaged Youth Project Fostering the Future Fund Foster Youth Housing Initiative California Youth Connection Honoring Emancipated Youth Alameda County Foster Youth Alliance Campaign for Safe Transitions Emancipation Resource Binder Early Start to Emancipation Preparation IV. Gaps in Service and Recommendations 43 Early Discharge of Foster Youth Increasing Support for Housing Interventions Employment Training Interventions Mental Health Needs of Youth Lack of Independent Living Skills Geographic Location of Sites Substance Use Education Lack of Social Support Rights of Foster Youth Pursuing Further Research Bay Area County Services and Initiatives Matrices. 55 A Call to Action Appendices Description of Bay Area Housing and Employment Programs References. 89 Tables Table 1: Current Outcomes of Youth Aging Out of Foster Care. 21 Table 2: Transitional Housing Placement Programs 27 Table 3: Transitional Housing Program-Plus Table 4: Federal HOME Funds. 29 Table 5: Permanent Housing Options Table 6: Transitional Living Programs. 33 4

5 EMANCIPATING FROM FOSTER CARE IN THE BAY AREA: What Types of Programs and Services are Available for Youth Aging Out of the Foster Care System? EXECUTIVE SUMMARY This BASSC Monograph examines the current needs of youth aging out of the foster care system and programs developed to assist youth with their transition to adulthood and independent living. It is based upon a review of the most up to date national and state empirical research to identify what the challenges youth aging out of care face. It is also based upon interviews with program administrators of Independent Living Skills Programs, communitybased organizations, and private foundations and endowments. The monograph is divided into the following four sections (along with an Appendices that includes an in-depth profile of the major community-based service providers in each county that serve youth aging out of foster care): Description of national and State of California outcomes, conducted in the last five years, of youth who have aged out of the foster care system Description of local, San Francisco Bay Area interventions, innovative practices, and major initiatives that have been developed for serving these youth. Identification of current gaps in services and limitations of services Major Research Findings The major research findings ( ) relate to the outcomes of older adolescents in foster care who have left care since the passage of the 1999 Foster Care Independence Act (known as the Chafee Act). Outcomes are for housing/homelessness, employment, achievement of financial selfsufficiency, receipt of public assistance, educational attainment, incarceration, mental health, substance use, social support and pregnancy. All studies examined in this monograph explored the outcomes for former foster youth between the ages of 18 and 24. A significant conclusion is that youth aging out of foster care still struggle to survive independently and do not do as well as young people in the general population. Former foster youth continue to lack employment experiences and educational attainment, and therefore still have to cope with homelessness, hunger, incarceration and receipt of public assistance. In fact, one study in particular, Courtney et al., (2005) examined 732 youth longitudinally, as they left care at 17 and 18 and again at age 19 (2 years after leaving foster care) in Illinois, Iowa and Wisconsin. 5

6 California Demographics There are 40,059 youth in out-ofhome placements between the ages of 11 and 21, and 11,600 are between the ages of 16 and 18 There are approximately 4,355 youth aging out every year Approximately 1,300 age out of care from the eleven San Francisco Bay Area counties (Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano and Sonoma). California Outcomes In terms of outcomes for youth in foster care in California, there has been one seminal study examining 10,228 youth who emancipated foster care between 1992 and The study, conducted by Needell, Cuccaro-Alamin, Brookhart, Jackman and Shlonsky (2002), found that these youth experienced many difficult outcomes. Approximately 65% entered the foster care system between ages 11 and 19 and 54% had five or more placements. The following outcomes are from the Needell et al., (2002) study: About 1/4 received TANF/AFDC within six years of leaving the foster care system 1/10 received Medi-Cal for a disability within six years after leaving care Low rates of high school graduation/proficiency, community college attendance, and graduation from 4-year colleges High rates of mental health services prior to emancipation (mood disorder was most common) 4% entered the California State Prison System within 7 years after leaving care Birth records showed that 2/3 of the females had at least one birth within five years after leaving care, and 1/5 gave birth within one year after leaving care Goerge, Bilaver, Lee, Needell, Brookhart & Jackman (2002) also conducted an outcome study of 2824 youth who aged out of the foster care system in California. 1/4 of these youth reported no income from employment 13 months after leaving care (yet 1/2 had employment earnings prior to their 18 th birthday). Of those youth who found employment, their mean earnings were $6235 per year Service Interventions: What is being done in the Bay Area? Housing There are a variety of housing program models, and more permanent funding options for such programs, for youth aging out of foster care, such as: Transitional Housing Placement Programs (THPP) are for youth ages 16 to 19. These programs are funded through the CDSS and licensed through community care licensing. They may be communal living or scattered site models. 6

7 Transitional Housing Placement-Plus (THP-Plus) programs are for former foster youth ages 18 to 24. Only three counties in the Bay Area are accessing State of California THP- Plus funds (Alameda, San Francisco, and Santa Cruz). Two cities in Alameda County (Fremont and Livermore) have utilized Federal HOME Funds to help fund supportive services for a THP-Plus program. Alameda and Kern counties have worked collaboratively with their county Housing Authority to develop programs and funding for youth aging out of care. Transitional Living Programs for youth ages 18 to 24 are often run through community-based organizations and are funded through private giving and HUD monies. Two counties, Alameda and San Francisco, offer a permanent housing option for homeless youth (former foster youth are eligible). San Mateo County offers Foster Youth Housing stipends for youth attending school/work for 30 hours per week. Education There are currently some school districts in the Bay Area that have developed specific program for foster youth in K- 12. There are now more funding and supports for youth accessing higher education through the Chafee Higher Education Grant and local Guardian Scholars Programs. Employment Training Employment training is mainly provided through community-based organizations, Workforce Investment Boards, and ILSP. Mental Health Mental health services for former foster youth under the age of 21 are primarily funded through State of California EPSDT monies. Other Initiatives There are numerous state-wide initiatives occurring with some Bay Area counties related to youth aging out of care. These are Family to Family, California Connected by 25, California Permanency for Youth Project, Family Finding, Gateway Project, and Fostering the Future Fund. Various Bay Area counties are participating in these initiatives and projects. A Call for Action Challenge 1: Cease Early Discharge of Foster Youth There is a need for the child welfare and judicial systems to examine the early discharge practices of older youth. In October 2005 the California state legislature passed a new law (SB 1633) requiring counties to allow GED preparation to count as working on high school proficiency. Consequently, older foster youth should be allowed to remain in county-funded foster care placement until age 19. However, it is unclear how this information is 7

8 being disseminated to county child welfare workers or to the juvenile courts that make the final decision about the closing of a foster care case. Also, as a result of this legislation, some youth may be required by their child welfare workers and the courts to leave high school and pursue a GED educational plan if they are not expected to graduate from high school before their 19 th birthday. This practice may need to be further examined in terms of youth s educational rights. Challenge 2: Increase Support for Housing Interventions A more thorough examination of the various housing options is needed. Counties (Social Services, Housing Authority), cities, and communitybased organizations can work collaboratively to ensure there are a variety of funding option and choices for youth aging out of care, depending on their needs. Challenge 3: Develop Creative ILSP and Employment Training Interventions for Disconnected Youth There is a lack of participation in ILSP and community-based employment training, especially for youth in foster care with mental health issues, geographic concerns, or behavioral issues. An examination of various program models (one-stop versus scattered site versus caregiver training) and developmentally-appropriate curriculum should be conducted. Challenge 4: Address the Mental Health Needs of Youth An emphasis should be placed on fully utilizing EPSDT monies. Counties could implement a Transitional Youth Mental Health Team to ensure a smooth transition for these youth from the foster care system, and perhaps into the adult mental health system. Lastly, Proposition 63 monies should be utilized for transitional youth leaving foster care for housing and other supportive services. Challenge 5: Assess and Treat Substance Use Given the high numbers of current and former foster youth utilizing alcohol and illicit substances, counties should examine utilizing an assessment tool for early intervention and prevention, and explore training in the area of substance use for child welfare workers. Exploration of starting a California CARE program in each county is also necessary. Challenge 6: Improve Education Outcomes Work with local school superintendents to offer more supportive foster youth programs such as been in the Oakland Unified School District s Social Services for Foster Youth Program. Advocacy is also needed to ensure non-public schools meet educational standards. Challenge 7: Increase Social Support Family Finding should be initiated, along with increased advocacy for CASA to work with older youth in care, and collaborations with mentoring programs should occur. Increased social support for lesbian, gay, bisexual, transgendered, queer, 8

9 or questioning youth is also imperative. Challenge 8: Educate Foster Youth about Their Rights and Privileges There is a lack of clear understanding about the rights and privileges or former foster youth among community-based organizations. Counties need to educate housing and other supportive service programs about the rights foster youth have upon emancipation, along with the various extras some youth can receive (i.e. money/stipends for housing or education, transportation passes, laptops etc). Mandated Emancipation Conferences should occur and all counties should develop and disseminate an Emancipation Binder to every youth aging out of care like the one now available in Contra Costa County. Challenge 9: Pursue Further Research More research is needed to fully understand the efficacy and client satisfaction of community-based and county services for youth aging out of care. Best practices can be emulated, but only if empirical research shows that such program are working for these young people. 9

10 EMANCIPATING FROM FOSTER CARE IN THE BAY AREA: What Types of Programs and Services are Available for Youth Aging Out of the Foster Care System? Introduction In the last decade there has been increased attention on youth aging out of the foster care system. Specifically, research has focused on how this population of young people has fared after emancipating from the foster care system (see Courtney et al., 2004; Cook, 1994; Courtney, Piliavin, Krogan- Gaylor, and Newsmith, 2001). These young people often leave the foster care system at the age of majority, or otherwise become legally emancipated (Needell et al., 2002). Unfortunately, most outcomes have been bleak (e.g. high unemployment, low educational achievement, homelessness, incarceration, high rates of public assistance, etc.). There has also been additional research related to outcomes of older foster care youth who access Independent Living Skills (ILS) program services in their counties of origin (see Lindsey and Ahmed, 1999; McMillen et al., 1997; Scannapieco and Shagrin, 1995; Waldinger and Furman, 1994). However, most of these studies had small sample sizes and weak methodology. Additionally, only a few of these studies were conducted in California, the state with the largest numbers of youth in care. It is important to note that there are limitations to the following literature review section. First, the empirical literature related to this population of youth often does not take a strengthsbased approach. There are, however, a few studies that have examined best practices with this population. These studies are mentioned in the following sections. Secondly, there are only few studies that have compared outcomes of former foster youth to those of the general population of transitional youth. Third, this report does not include information from birth/biological families or foster families. It is also important to note the difficulties in studying a representative sample of former foster youth, given how few remain in contact with social service agencies after they emancipate. California Outcomes In California, children enter the foster care system under the auspices of either county child welfare services or probation departments (Needell et al., 2002). The state has the largest foster care population in the United States (97,261 as of September 30, 2003). In July 2002 there were 40,059 youth ages 11 to 18 in its child welfare system. This age group represents 46% of all children in California in supervised foster care. Of these youth, 11,600 (29%) are between the ages of 16 and 18 (U.S. DHHS, 2004). Approximately 4,355 foster youth leave the California foster care system each year (CDSS, 2002). The majority of these young people leave care at age 18 10

11 (72% for child welfare and 69% for probation), but many emancipate before age 18 (15% for child welfare and 28% for probation). About one-third of these young people have had five or more placements and 41% have been in care for 5 or more years (Needell et al., 2002). Between 2000 and 2001 approximately 65% of the youth aging out needed affordable housing at the time of emancipation (Needell et al., 2002) and 30% were linked to TANF after leaving care. Also, former foster youth from California have high rates of publicly funded mental health services (53%), Medi-Cal insurance (59%), and pregnancy (20% are mothers within 1 year of leaving the system) (Needell et al., 2002). Of the 4,355 youth that leave care in California, it is estimated that are from the San Francisco Bay Area (CDSS, 2002). Yet, there is very little information about these young people. A study by Rashid, Doherty and Austin (2001) explored what Independent Living Skills Program services are available for Bay Area older adolescents in foster care. Barth (1990) interviewed 55 youth, from the San Francisco Bay Area, at least one year after leaving foster care. These youth reported significant monetary troubles and one third admitted to committing crimes just to survive. Yet, no comprehensive study in the Bay Area has examined what current services are available to foster care youth (in addition to county ILSP services) or the best practices of such services. Housing, employment preparation, educational support, mentoring, and independent living skills training will be examined in this monograph. Qualitative interviews were conducted with key constituents serving youth aging out of the foster care system in the Bay Area. Findings from this study will provide county social service directors, child welfare administrators, philanthropic organizations, non-profit service providers, and policy makers with important information about the services and funding opportunities available for older youth in foster care in the Bay Area since passage of the Chafee Act in General Outcomes for Adolescents in Placement There are approximately 523,085 children and adolescents in out-of-home care in the United States (AFCARS Report, 2005) and about 20% of these youth are older adolescents. In fact, about 105,000 adolescents ages 16 to 21 years were in care, and another 75,000 are between the ages of 14 and 15 years old (Casey Family Programs, 2000). While many of the studies cited in the following review of the literature relate to high risk populations, the different populations studied or the methodologies used may not always apply directly to the foster care population as a whole. Youth aging out of foster care Of the 105,000 older adolescents in foster care each year approximately 34,600 have case plans with emancipation as the treatment plan (ACF, 2001). It is estimated that 7% of all of the young people in foster care (about 38,000) emancipated from the system in 2000 (U.S. DHHS, 2003). 11

12 However, many youth experience significant challenges in making the transition from the out-of-home placement system to independent living (U.S. GAO, 1999). Unfortunately, many young people that exit the out-of-home care system as adolescents ultimately receive services as adults either through the criminal justice system, the welfare system, or as residents of homeless shelters (Casey Family Programs, 2000). Their lack of self-sufficiency may be traced to limited life skills, education, employment, and social skills. The following sections describe the most recent empirical research addressing the outcomes of youth aging out of out-of-home care. The majority of youth placed in foster care as adolescents remain in care until they reach 18 years old and emancipate. Fanshel, Finch & Grundy (1990) examined 585 youth in care with a mean age of first placement being years (standard deviation 2.99 years). The researchers found that 55.5% were emancipated, 20.2% reunified with parents, 20.7% transferred, and 3.9% ran away by the time the case closed. Housing and Homelessness One of the most important changes youth will make in the transition to independent living and self-sufficiency is assuming the responsibility for housing (Sheehy et al., 2000). Yet, homelessness is another serious outcome for many youth aging out of care. A number of studies have shown that either temporary or permanent homelessness can result after emancipation; homelessness is defined by all studies as at least one night living on the streets or in a shelter. Homeless young people, who have been cast out, abandoned, or rejected by their families, frequently experience multiple placements in group homes or treatment centers as permanent wards of the state (Morrissette & McIntyre, 1989 p. 603). Often, they were taken into state custody and placed in unsuitable or inappropriate placements, and when the placements became intolerable, some youth ran to the streets (Kurtz et al., 1991). Other youth become homeless after leaving care. There are estimates that between 20 and 50% of youth accessing homeless agencies have a history of foster care or have run directly from care (Kurtz et al., 1991; NASW, 1993, Larkin Street Youth Services, 2001). A seminal study was recently conducted by Chapin Hall Center for Children through the University of Chicago. The researchers, Courtney, Dworsky, Ruth, Keller, Havlicek, and Bost (2005) followed approximately 750 youth two years after leaving foster care from Illinois, Iowa and Wisconsin. Follow-up data was collected on 603 youth (of the 736 that participated in baseline interviews 1-2 years earlier). The median age of the 603 youth was 19. Of those youth no longer in care (n=321) only 1% were currently homeless at the time of the interview. However, 14% reported being homeless at least once since leaving foster care. Pecora et al., (2003) examined the outcomes from the Northwest Foster Care Alumni Study of former foster youth who were in care in Oregon and Washington between 1988 and The study found that of 659 alumni 12

13 (average age at interview was 24.2 years), 22% reported being homeless for one day or more after the age of 18. Housing Service Outcomes At present there is a dearth of research examining the outcomes of former foster youth that access transitional living programs that are developed to assist them with the move to adulthood. Throughout the nation there are approximately 200 programs to assist these young people, yet there is little empirical information about the effectiveness of these programs. Rashid (2004) examined the outcomes of a transitional living program that served former foster youth ages 18 to 23. The goals of this study were to: 1) assess the outcomes of former foster care youth utilizing transitional living programs and 2) compare outcomes achieved by former foster care youth who participated in an employment training program with similar youth who did not. The study sampled 23 former foster care youth using transitional living services in San Francisco County. Hourly wage, money saved, and employment status outcomes were examined at discharge and housing outcomes were examined at six month post-discharge. All outcome variables demonstrated improvement post-intervention; hourly wage, housing situation, employment, and money saved. At six month follow-up 90% of youth with known housing situations (18 of 23 youth) were in permanent, stable housing. In comparing youth with employment training and those without on hourly wage, those youth with comprehensive employment training had significantly higher hourly wages. This study illustrates that transitional living programs coupled with employment training may be effective interventions for former foster care youth (Rashid, 2004). Mallon (1998) examined the outcome data of 46 youth who discharged from a residential independent living program in New York between 1987 and All participants were male and were between the ages of 16 and 23 while in the program. The outcome data shows approximately 72% of the 46 youth had full-time employment and 74% had received a high school diploma or GED (General Equivalency Diploma) when they exited the program. Follow-up was completed on all 46 youth after they had left the program for at least six months. It was found that 76.5% lived in independent living situations and 15% lived with family members. A limitation to this study is that there was no control group. Employment and financial selfsufficiency Courtney, Terao, and Bost (2004) surveyed 732 foster care youth, with a median age of 17, prior to leaving care. The researchers found that 47.7% of the youth had been employed at some point in the past and 35% were currently employed at the time of the survey. The average hours worked per week was 25 and the median was 27. Approximately 30% of the young people reported that they obtained their employment through either job corps or another job training program, which illustrates that training may play an important role in these youths employment (Courtney et al., 2004). It is important to note, however, that 50% of the young people in the 13

14 overall sample reported still needing future assistance with employment problems even though 67% reported they had participated in a vocational support program. Clearly, youth recognize that employment training and support may be needed even after youth exit foster care, during their transitional years. The Courtney et al. follow-up study (2005) conducted with 321 former foster youth illustrated that although 72% had worked for pay during the last year, only 47% were currently employed at the time of the survey. Additionally, of those who had worked for pay, 84% made less than $9.00 per hour. These employment outcomes show that youth may struggle to survive financially. In fact, 40% of youth reported not having enough money to buy clothes, 20% did not have enough money to pay rent, and 22% had their phone service disconnected. The same study found that 37% of the 321 former foster youth reported being not in school and not employed. Additionally, almost 40% were not in school and not employed, or homeless, or incarcerated at the time of the interview. These numbers illustrate the high rates of disconnectedness among this population of young people (Courtney et al., 2005; Wald and Martinez, 2003; Youth Transition Funders Group, 2004). Lastly, Courtney et al. (2005) found that 15% of participants reported being hungry because of not having enough money to buy food and 28% had received food or money for food from family or friends. Additionally, over one-quarter of participants could be deemed as food insecure by the USDA s food security measure. In terms of receipt of government assistance, Courtney et al. (2005) found that 36% of former foster youth had received food stamps at some point since emancipating and 22% were currently receiving food stamps. And, 17% of the parenting former foster youth were currently receiving TANF. Goerge, Bilaver, Lee, Needell, Brookhart & Jackman (2002) conducted an outcome study of 4213 youth who aged out of the foster care system in California (n=2824), Illinois (n=1084) and South Carolina (n=305) during the mid-1990s. The study examined employment rates, as well as earned income from employment during a 13- month period. Participants outcomes were compared with those who were reunified with their parents prior to their 18 th birthday and those who were from low-income families. Results indicated that the former foster care youth s unemployment rates varied from state to state (30% in Illinois, 23% in California, and 14% in South Carolina). Youth aging out of the foster care system earned significantly less than youth in any comparison group both prior to and after their eighteenth birthday. In fact, the former foster care youth averaged less than $6000 per year in wages, which was substantially lower than the 1997 poverty level of $7890 for a single individual (Goerge et al., 2002). Pecora et al. (2003) found that of 659 alumni (average age at interview was 24.2 years), 80% reported being employed full-time or part-time. However, their overall employment rates were lower than that of the general 14

15 population and 33% had household incomes at or below poverty level. Also, 17% were currently receiving cash assistance and 33% had no health insurance (almost twice the rate of the general population of adults ages 18 to 44). Employment Training Outcomes Courtney et al. (2005) found that of the 321 former foster youth surveyed, only 63% reported never having received employment or vocational training with ILSP. Training included such things as resume writing, job application and interviewing skills, or help with job referrals or placements. Homeless former foster youth have historically been overlooked in studies examining employment training. Lenz- Rashid (2005) examined the baseline information and outcomes following a comprehensive employment training program for 104 homeless former foster youth. The mean age of the sample was years (1.40 s.d.) with 39% of the youth African American, 29% Caucasian, 12% Latino/a, and 20% Other. Approximately 66% had a mental health issue and 46% had a current substance abuse issue. Although all youth in the sample were over the age of 18 at the time of the study, only 50% reported having a high school diploma or proficiency. Approximately 60% of the study participants found employment within three months following the training and the mean hourly wage of all participants post-training was $8.88. Follow-up comparisons found that having a mental health issue most significantly predicted whether a youth found employment following the employment training program, even while taking into consideration foster care history and all other control variables. Financial self-sufficiency and finding stable housing are two of the most important elements to achieving independence. Youth that emancipate from foster care are clearly at a high risk of not retaining stable housing and not being able to support themselves financially, which can lead to homelessness and dependency on others. Education Educational deficits have also been found in numerous studies among youth who have emancipated from out-ofhome care (Courtney et al., 2000; Festinger, 1983). Courtney et al s. (2005) follow-up study found that of the 321 former foster youth interviewed, more than 36% reported they did not have a high school diploma or GED. Only 7.9% of those participants were enrolled in a 2-year college and only 3.8% were enrolled in a 4-year college. Pecora et al. (2003) found that of 659 alumni (average age 24 years), 65% reported seven or more school changes from elementary through high school, 85% had completed high school diploma or GED credential, and 43% received some education beyond high school. Approximately 21% completed a degree or certificate beyond high school, but only 1.8% had completed a bachelor s degree. In fact, the youth in this study were 14 times less likely to complete college than the general population. 15

16 Buehler et al. (2000) discovered that participants with a history of foster care were not statistically different from nonfoster care participants, or a matched group, in educational attainment (choices were categorized as: less than high school, high school, some college or post high school training, college degree, post baccalaureate). Yet, when examining the variable education dichotomously ( high school or less and more than high school ) the authors found that the non-foster care participants were significantly more likely to report having a high school degree or more than the foster care and matched groups. Adults in the foster care and matched groups did not differ on this dichotomous measure of educational attainment (Buehler et al., 2000). Clearly there are some discrepancies in the educational achievements of youth in care when compared to youth not in care. Whether these discrepancies are due to a lack of ability due to upbringing, a non-supportive home-life, or minimal residential stability, there is one thing apparent; youth in care tend to fare worse educationally than the general population of youth that reside with their families. Mental Health Needs The data documenting special needs of youth aging out of care are largely unavailable, incomplete, or unreliable from most states (Casey Family Programs, 2000). For the purpose of this paper, special needs is defined as a diagnosed disability; vision or hearing impairment, mental retardation, physical disability, emotional disturbance, other medical condition, child behavior problem, substance abuse problem, or receipt of Social Security Insurance. This information was gathered from the Adoption and Foster Care Analysis and Reporting System (AFCARS) database. Approximately 80% of foster youth have received services for their mental health needs. Pecora et al. (2003) found that of 659 alumni (average age 24 years), 54% had one or more mental health diagnosis. In fact, 25% held a post-traumatic stress disorder diagnosis (a rate nearly double that of U.S. war veterans), 20% held major depressive disorder, and 17% were diagnosed with social phobia. About 90% received mental health services while in care. Courtney et al. s (2005) study showed that 12% of 321 former foster youth surveyed had a lifetime diagnosis of Post-Traumatic Stress Disorder (PTSD) and 10% for Major Depressive Disorder (based on the Composite International Diagnostic Interview CIDI). Also, 11% (at median age 19) were most recently hospitalized for a mental health or substance abuse issue in the last year. PTSD and Major Depression were more prevalent among females. Thirteen percent had received counseling in the last year and 15% had received medication for mental health issues. Buehler et al. s (2000) study of three samples of 101 participants (those with a history of foster care, those matched on demographic variables, and those randomly sampled with no history of foster care) compared the three groups on mental health outcomes. Two measures of mental health were examined: self-esteem and depressive affect. Self-esteem was measured using 16

17 the Rosenberg Self-Esteem scale and there were no differences found between the three groups. Depressive affect was measured using the mean of 12 frequently used items (e.g. feel depressed, feel sad, feel overly bothered by things) (p. 618). Participants were asked to note the number of days during the past week they had experienced each of these feelings. There were no statistically significant group differences. Social Support There are various kinds of social support young people can receive: emotional support (e.g. someone to share your worries with), tangible support (e.g. someone to take you to the doctor), and recreational support (e.g. someone to spend time with having fun) (Courtney et al., 2005). Courtney et al. (2005) examined the level of reported social support of 321 youth who had already left foster care by using the MOS Social Support Survey (Sherbourne and Stewart, 1991). Responses were rated on a five point Likert scale (0 = none of the time, 5 = all of the time). Youth reported receiving the lowest rates of social support with emotional support and tangible support (between some and most of the time) and the highest rates for recreational (i.e. fun) support (between most and all of the time). The Buehler et al. (2000) study explored the variable relations with biological family. This was defined as the respondent s perception of the quality of the relationship with his or her biological mother and father and siblings, and was analyzed using a 7-point scale. The scale ranged from very poor to excellent. Adults in the foster care group had poorer quality relationships with their mothers and fathers than the adults in the random sample and the matched groups. Similarly, the adults in the foster care group got along less well with their siblings than did adults in the other two groups. In addition to familial relationships, community involvement was also assessed. Involvement in community activities was assessed by asking the frequency of involvement in fifteen community groups (e.g. service clubs, church, school groups, sports groups). Adults in the foster care group were less involved in community activities than adults in the random group, but did not have a significantly different level of community activities than the matched group. LGBTQ Youth Lesbian, gay, bisexual, transgendered, and queer/questioning (LGBTQ) youth aging out of foster care are often overlooked in child welfare services, especially when they choose not to selfidentify. They may suffer a host of problems because of discrimination, harassment and abuse based on homophobia, misinformation, lack of information, and prejudice against their sexual orientation, perceived orientation, or their lack of conformity to gender stereotypes (Richardson, Early and Rivera, 2005). Although the legislature passed the California Foster Care Nondiscrimination Act which ensures fair and equal access to services and prevents discrimination and harassment, 17

18 there are no formal instruments used to identify youth who are LGBTQ in the State of California. Counties should decide whether identifying these LGBTQ older youth in foster care may, in fact, provide some them with extra support. Identification may provide an opportunity for advocacy from these young people s child welfare workers, especially when related to placement decisions. Mallon s (1998) research on the needs of LGBT youth in out-of-home placements told the stories of 54 youth interviewed. They described incidences of being beaten, raped, physically abused, ignored, coerced, attacked, taunted, evicted from placement, belittled, forced into aversion therapy, and called derogatory names by peers, foster parents and group home staff, because of their known or perceived sexual identity. Consequently, some youth try to hide their sexual identity, or try to pass as straight, to avoid these abuses (Richardson et al., 2005). Courtney et al. (2005) found that 15% of 321 former foster youth reported being LBGTQ. In fact, approximately 20% of the females and 10% of the males in the study reported being of a sexual minority. Lenz-Rashid (2005) found that thirtyfour percent of 104 homeless former foster youth reported being LGBTQ. Although the study utilized a nonrandom sample, the high percentages of LGBQ former foster care youth raises the question as to whether these young people receive adequate support while in and upon exiting foster care. These foster care youth might, in fact, have fewer housing options after exiting care than heterosexual youth as a result of not feeling supported by their family of origin or friends regarding their sexual orientation, or not comfortable with coming out as gay, lesbian, or bisexual (Remafedi et al., 1992). By not receiving emotional and social support around their sexual orientation, or by being stigmatized or victimized, these youth might experience increased mental health and substance use issues. These issues could affect their transition into adulthood, as well as their ability to obtain and retain employment and housing. Substance use There is little empirical research examining the substance use habits of current and former foster care youth. Of the research available, there are vast differences in outcomes due to sampling, methodology, and instruments. A limitation to the studies below is that outcomes were not distinguished among placement types. Between 1998 and 1999 Kohlenberg, Nordlund, Lowin, and Treichler (2002) interviewed 231 foster youth anonymously by phone and asked about their substance use. The results showed that foster youth were more likely than adolescents living with their parents to have lifetime use and use within 6 months that constitutes a DSM III substance abuse diagnosis or a current need for treatment. However, foster youth had less past year and last 30 day use than adolescents housed with parents. Courtney et al. (2005) found that 15% of 321 former foster youth had a lifetime 18

19 diagnosis of Substance Abuse and 5% had a diagnosis of Substance Dependence (based on the CIDI). Additionally, 14% have a lifetime diagnosis of Alcohol Abuse. Alcohol and Substance Abuse were more prevalent among males than females. Seven percent had received substance abuse treatment in the last year. Courtney et al. (2004) interviewed 732 youth leaving foster care with a median age of 17 and found that 11% reported alcohol abuse symptoms, 3% reported alcohol dependence symptoms, 5% reported substance abuse symptoms, and 2.3% reported substance dependence symptoms. Similarly, English et al. (1994) used case record review and phone interviews with caregivers to explore the substance use behaviors among 464 youth in care. Alcohol use by the youth was reported among 16% of the cases, while drug use was disclosed by approximately 15%. An enormous limitation to this study is that caregivers were surveyed, and not the youth themselves. Morehouse & Tobler (2000) examined the frequency of substance use among 132 adolescents currently living in residential facilities; foster homes, facilities for juvenile offenders, treatment centers for adolescents with psychiatric problems, and correctional facilities. The participants in the program were high risk, multi-problem, and inner-city youth, primarily of African-American and Latino decent (Morehouse et al., 2000). Of those surveyed, 45% reported using alcohol, 45% using marijuana, and 3% using cocaine in the prior 30 days. Lenz-Rashid s (2005) study of 104 former foster youth ages 18 to 23 found that 46%, reported some alcohol or illicit substance use in the 30 days prior to the intake being conducted. Incarceration Courtney et al. (2005) found that of the 321 youth who had aged out of care and now had a median age of 19, 34% had been arrested, 17% had been convicted of a crime, and 24% had spent at least one night in jail, prison, juvenile hall, or other correctional facility since the last interview for the study (when the participants had a median age of 17). Spatz-Widom (1991) explored the role of placement experiences, in relation to adult criminal, delinquent, and violent criminal outcomes, of a sample of 772 juvenile court cases of child abuse and neglect from the late 1960s. The mean current age of the subjects was years (SD = 3.53) and the majority of them (85%) were between the ages of 20 and 30 at the time of the study. It was found that children with no history of care or a history of only foster care had lower rates of any type of arrest than youth placed in group home care or in probationary placements. Therefore, what have often been viewed as negative (criminal) outcomes of foster care may be due to the confounding influences of a small fraction of children in foster care who have early involvement in criminal activity (p. 204). This study illustrates that it is not accurate to assume all foster youth are at higher risk of future incarceration; it is important to distinguish between youth who are in care due to abuse or neglect and those youth who are in care because of abuse and neglect and as a result of 19

20 their delinquent behavior (Spatz-Widom, 1991). While the national and state research have been the focus of this study up until this point (see Table 1 for summary of outcomes), it is also important to examine the specific current services available in the San Francisco Bay Area. This is the focus of the next section. 20

21 Table 1 Recent Studies on Youth Aging Out of Foster Care Outcome Area Study Findings Homelessness California Department of Social Services (2002) 65% of California youth needed affordable housing at the time of emancipation Courtney et al. (2004) Courtney et al. (2005) Pecora et al. (2003) 25% of foster youth experienced homeless for at least one night (n=732) 14% reported being homeless for at least one night since leaving care (n=321) 22% were homeless for at least one night after leaving care (n=659, average age at interview was 24.2 years) Employment Courtney et al. (2005) 47% reported being unemployed at the time of the interview and 84% reported making less than $9.00 hour when they did have work (n=321) Barth (1990) Goerge, Bilaver, Lee, Needell, Brookhart & Jackman (2002) Pecora et al. (2003) 53% of foster youth reported having serious money troubles (n=55) 23% did not find employment 13 months after leaving care in California (n=2824) 84% reported being employed full or parttime after leaving care (n=659) Education Courtney et al. (2005) 36% did not have a high school diploma or GED achieved, 7.9% were enrolled in 2- year college, and 3.8% were enrolled in 4- year college 2 years after leaving care (n=321) Financial Self- Sufficiency Pecora et al. (2003) Courtney et al. (2005) Pecora et al. (2003) 85% had achieved a high school diploma or GED, 21% had achieved a 2-year degree or certificate and 1.8% had achieved a bachelor s degree after leaving care (n=659) 36% of former foster youth had received food stamps at some point since emancipating, 22% were currently receiving food stamps and 15% reported being hungry. 17% of the parenting former foster youth were currently receiving TANF (n=321) 33% had household incomes at or below poverty level. Also, 17% were currently receiving cash assistance and 33% had no health insurance 21

22 Outcome Area Study Findings Mental Health AFCARS (2003) 80% of youth in foster care have received services for mental health issues during placement Pecora et al. (2003) 54% have a mental health diagnosis after leaving care (n=659) Courtney et al. (2005) Needell et al. (2002) 12% and 10% had a lifetime diagnosis of PTSD and Major Depressive Disorder respectively (n=321) 62% had received mental health service prior to emancipation (n=10,228) Substance Use Courtney et al. (2005) 15% had a lifetime diagnosis of Substance Abuse and 5% had a diagnosis of Substance Dependence (based on the CIDI). Additionally, 14% have a lifetime diagnosis of Alcohol Abuse (n=321) Courtney et al. (2004) 732 youth leaving foster care with a median age of 17: 11% reported alcohol abuse symptoms, 3% reported alcohol dependence symptoms, 5% reported substance abuse symptoms, and 2.3% reported substance dependence symptoms Morehouse and Tobler (2000) Kohlenberg et al (2002) 45% reported using alcohol, 45% using marijuana, and 3% using cocaine in the prior 30 days (n=132, youth were in care) Foster youth more likely than adolescents living with their parents to have lifetime use and use within 6 months that constitutes a DSM III substance abuse diagnosis or a current need for treatment, BUT have less past year and last 30 day use than adolescents housed with parents. (n=231) Incarceration Courtney et al. (2005) 34% had been arrested, 17% had been convicted of a crime, and 24% had spent at least one night in jail, prison, juvenile hall, or other correctional facility since leaving care for 2 years (n=321) LGBTQ Youth Courtney et al. (2005) 15% of the former foster youth reported being LBGTQ (20% female and 10% males) (n=321) Lenz-Rashid (2005) 34% of the homeless former foster youth reported being LBGTQ (n=104) 22

23 Description of Bay Area Interventions The previous sections have examined what is currently known about the various outcomes for youth aging out the foster care system at both the national and State of California levels. It provides an important foundation for examining the current services available for this population. This section describes the independent living, housing, employment, mental health, and educational services available in twelve Bay Area and surrounding counties: Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma and Stanislaus. The data were gathered through interviews with program administrators of Independent Living Skills Programs, communitybased organizations, and private foundations and endowments, along with a review of program materials from community-based organizations. This section is divided into an overview of program components and a description of selected innovative services and cross-agency collaborations. The next main section contains a summary of current gaps in service and recommendations for Social Service and Child Welfare Directors to address these gaps. It is important to note that there are limitations to this study. For example, one large area missing from this analysis is the families perspective of services. Independent Living Skills Programs A monograph was completed in 2001 by the Bay Area Social Services Consortium (BASSC) that examined the needs of youth aging out of the foster care system and the Independent Living Skills Programs (ILSP) that assist youth with their transitions to independent living (see Rashid et al., 2001). The policy monograph was based upon a review of the national research and policy literature to identify what is known about this population of young people, and what county social service agencies were doing to address their needs. Specifically, qualitative interviews were conducted with nine county ILSP Coordinators to explore what services were available to youth between the ages of 16 and 21. The counties included in the study were: Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, and Sonoma. The main outcomes of this study illustrated seven specific challenges: 1) Strengthening ILSP recruitment and retention, 2) Increasing support for ILSP from foster care providers, 3) Addressing the need for housing, 4) Serving the special needs of youth, 5) Clarifying the role of counties in serving out-of-county youth, 6) Enhancing database systems, and 7) Pursuing further research. BASSC workgroups were convened in February, 2003 to more thoroughly examine these challenges. Since the 2001 monograph there have been few significant changes to county ILSP services in the Bay Area. For example, Santa Clara County now more fully contracts out its ILSP services with other community-based organizations. Other counties have developed Youth Speaker s Bureaus to educate those involved in child welfare and the general population, about their unique needs 23